Yini abazali okufanele bayazi nge-Reye's syndrome

Imfundo Yezempilo

Yini iReye's syndrome? | Izimpawu | Ukuxilongwa | Ukwelashwa | Ukuvimbela

Uma ungumzali, kungenzeka wazi ukuthi akufanele unikeze i-aspirin enganeni enenkukhu noma umkhuhlane. Isizathu salokhu ukwehlisa ubungozi besimo esibucayi kanye nesifo esingahle sibulale esibizwa ngeReye's syndrome, noma iReye syndrome, esingadala ukungasebenzi kwesibindi nokuvuvukala ebuchosheni futhi sixhunyaniswe nokusetshenziswa kwe-aspirin ezinganeni nasentsheni ene-virus izifo ezinjengomkhuhlane, i-varicella (ebangela ingxibongo), izifo ezingaphezulu zokuphefumula, kanye ne-COVID-19, ebangelwa i-coronavirus yenoveli.

Ngo-1980, iCenters for Disease Control and Prevention (CDC) yaqopha amacala angama-555 we Isifo sikaReye e-United States. Ngenhlanhla, ngawo lowo nyaka kwaqala izixwayiso ezisabalele ngokusetshenziswa kwezingane i-aspirin ezinganeni , futhi kusukela ngo-1994 kuye kwabikwa amacala angaphansi kwamabili unyaka ngamunye ezweni lonke.

Ngama-80s, cishe ingane eyodwa kwezingu-100 000 yayithola — manje, icishe ibe ngu-1 esigidini, kusho u-Amy Cram, MD, udokotela wezingane INortheast Medical Group . Lokho ikakhulu kungenxa yokuthi siyazi ukuthi ukusebenzisa i-aspirin njengesinciphisi somkhuhlane noma ukulwa nokuvuvukala kwandisa ubungozi.

Iningi lezingane (cishe ama-80%) ezithola i-Reye's syndrome ziyasinda, kepha zidinga ukwelashwa ngokushesha, kaningi egumbini labagula kakhulu esibhedlela. Uma ishiywe ingalashwa, i-Reye's syndrome ingaholela ekulimaleni okungapheli kobuchopho noma ekufeni ezinsukwini ezimbalwa nje.

OKUSHIWO: Yikuphi ukudambisa izinhlungu okuhle noma ukunciphisa imfiva ezinganeni?

Yini iReye's syndrome?

I-Reye's syndrome ukugula okutholakala njalo ezinganeni nasebancane abangaphansi kweminyaka engu-18— imvamisa labo abaneminyaka engu-4 kuya kwengu-12 ubudala —Kodwa kungathinta abantu banoma isiphi ubudala. Odokotela abazi kahle kahle ukuthi yini ebangela iReye's syndrome, kodwa njalo ilandela okunye ukugula futhi imvamisa ixhunyaniswa nokusetshenziswa kwemithi equkethe i-aspirin ezinganeni ezinesifo segciwane.

I-Aspirin, eyaziwa nangokuthi i-acetylsalicylic acid, i-salicylic acid, noma i-acetylsalicylate, isidakamizwa esisiza kakhulu esisusa izinhlungu emlandweni . Isebenza ngokuvimbela ukukhiqizwa komzimba kwama-prostaglandin, okuyizinhlanganisela ezikhiqizwa ama-enzyme emzimbeni adlala indima ebalulekile ekuphenduleni komzimba ekutheleleni noma ekulimaleni.

Uma isetshenziselwa ukugula okunegciwane, i-aspirin ingathinta i-mitochondria yomuntu, okuyizinto ezincane ezisemangqamuzaneni abizwa ukuthi akhiqiza amandla okuqhuba iseli.

I-Aspirin ekubekweni kwesifo segciwane, njengomkhuhlane noma inkukhu, ibanga ukulimala kwesibindi kwe-mitochondrial, kusho uNathan Friday, Pharm.D., Usokhemisi UKroger . Futhi lokhu kubangela ukungasebenzi kwesibindi.

Lokhu kungasebenzi kahle kwe-mitochondrial kungaholela ekwakhiweni kwe-ammonia-umkhiqizo we-metabolism-egazini. Lesi simo, esibizwa nge-hyperammonemia, singaholela ekuqhumeni ebuchosheni nasekunyuseni ingcindezi ebuchosheni njengoba icindezela ukhakhayi. Inani lokuvuvukala kanye nengcindezi kunquma ubunzima bezimpawu zomuntu zomuntu.

Izimpawu zesifo sikaReye

Yize kuthinta zonke izitho zomzimba, iReye's syndrome iyona ebulala kakhulu ubuchopho nesibindi. Yingakho, ngokwemigomo yezokwelapha, ichazwa ngokuthi: i-acute noninfigueatory encephalopathy enokwehluleka kwesibindi okunamafutha. I-Encephalopathy, isimo esiguqula ukusebenza noma ukwakheka kobuchopho, uphawu oluyingozi kakhulu lweReye's syndrome, kodwa kunzima kakhulu ukubona kuze kube yilapho umonakalo usuvele wenzekile ebuchosheni futhi izimpawu zesifo zibonakala.

Izimpawu zivame ukuvela ezinsukwini ezintathu kuya kwezinhlanu ngemuva kokuqala kokutheleleka ngegciwane futhi imvamisa ziqala ngokuhlanza okungazelelwe, okuqhubekayo, yize ezinganeni ezineminyaka engaphansi kwemibili ubudala, isibonakaliso sokuqala kungaba uhudo . Ukuhlanza ngokuvamile kulandelwa ukukhathala okwandayo noma ukulala okungavamile; kodwa-ke, izingane ezingaphansi kwezinyanga eziyi-12 zingaletha ngaphandle kokuhlanza. Izimpawu ze-Neurologic bese ziqala ukuvela emahoreni angama-24 kuya kwangu-48 alandelayo futhi zingafaka:

• ukucasuka
• ukungahlaliseki
• ukudideka
• izinguquko zobuntu
• inkumbulo engasebenzi kahle

Njengoba ukugula kuqhubeka ngokushesha futhi ubuchopho buqhubeka nokuwohloka ngenxa yokuvuvukala nengcindezi, ezinye izimpawu zingafaka:

• abafundi abahlanzekile
• ukudideka noma ukudideka
• ukusangana
• ukuphefumula okungajulile noma okusheshayo
• ukushaya kwenhliziyo okusheshayo
• ukulahlekelwa ukwazi

Ngaphezu kwezimpawu zayo ze-neurologic, i-Reye's syndrome nayo ingadala ukuqoqwa okukhulu kwamafutha esibindi nakwezinye izitho. Ubukhulu bezimpawu kanye nokubikezelwa kokululama kuyahlukahluka kakhulu futhi kuncike enanini lomonakalo owenziwe ebuchosheni. Abanye abantu banezimpawu ezimnene futhi bayalulama ngokugcwele. Abanye basala nezinga elithile lokukhubazeka kwengqondo noma komzimba.

Ezimweni ezimbi kakhulu, ukulimala ebuchosheni kungaholela ekuqulekeni, ukukhubazeka ezingalweni nasemilenzeni, ekuqulekeni, ekugcineni kugcine ngokufa. I- isilinganiso sokufa seReye's syndrome wake waba cishe ngama-50%, kepha lelo nani lehle laya ngaphansi kuka-20% eminyakeni yamuva.

Ixilongwa kanjani i-Reye's syndrome?

Ukuxilongwa nokwelashwa kwasekuqaleni kubaluleke kakhulu nge-Reye's syndrome, ngakho-ke noma yiluphi usana, ingane, noma osemusha osanda kuba nokutheleleka ngegciwane futhi akhombisa noma yiziphi izimpawu ze-Reye's syndrome kufanele ayiswe egumbini lezimo eziphuthumayo esibhedlela ngokushesha okukhulu. Ukuze uthole ukuxilongwa okufanele, kubalulekile ukuthi abanakekeli banikeze umlando wezempilo oningiliziwe konke imishanguzo, kufaka phakathi i-counter, i-supplements, namavithamini, okuthathwe yisiguli.

Ukuxilongwa ngokuvamile kuqala ngokuhlolwa kwegazi nokuhlolwa komchamo ukubheka izinto ezinjengamazinga aphakeme e-fatty-acid noma ama-ammonia egazini. Ukuhlolwa kwamakhemikhali wesibindi, ikakhulukazi, kungasiza. Imiphumela ingaba isilungile kungakapheli amahora ambalwa, futhi izivivinyo zingathola amazinga aphakeme ama-enzyme athile akhiqizwa isibindi egazini. Amazinga aphezulu ala ma-enzyme ayisibonakaliso esingahle sibe se-Reye's syndrome.

Ezinye izinkinga eziningi zingadala izimpawu ezifana ne-Reye's syndrome, ngakho-ke ingxenye yokuxilongwa izoba nemibandela yokulawula izimo ezifana nalezi:

• ukuphazamiseka kwe-fatty-acid oxidation nezinye izindaba zomsebenzi wesibindi
• amaphutha azalwa nawo we-metabolism kanye nokunye ukuphazamiseka komzimba
• ukusetshenziswa kwezidakamizwa, ukungenisa, noma ukuvezwa ubuthi
• izifo zesistimu yezinzwa eziphakathi ezifana ne-encephalitis (ukuvuvukala kobuchopho) ne-meningitis (ukuvuvukala kolwelwesi oluvikelayo oluzungeze ubuchopho nomgogodla)
• ukugula ngengqondo

Kwezinye izimo, umpompi womgogodla ungenziwa ukuthola ingcindezi eyengeziwe emzimbeni we-cerebrospinal fluid (CSF) womzimba. Kule nqubo, ebizwa nangokuthi i-lumbar puncture, inaliti ifakwa emuva emuva iye esikhaleni eceleni kwekholamu lomgogodla, bese kukhishwa inani elincane le-CSF ukuze lihlolwe. Ukwanda kwengcindezi yokungasebenzi kahle kwesinye isikhathi kungatholwa nge-magnetic resonance imaging (MRI) noma ukuskena nge-computerised tomography (CT), kanti odokotela banga-oda olunye lwalezi zivivinyo ekuhloleni imbangela.

Ukwelashwa kwe-Reye's syndrome

Ukwelashwa kwe-Reye's syndrome kufanele kuqale ngokushesha okukhulu ukusiza ukwehlisa ukuqhubeka kwesifo.

Ngesikhathi izingane ezine-Reye's syndrome [noma ingane ene- noma yini ukugula] banoshintsho esimweni sabo sengqondo (izinga labo lokuqwashisa nokuqwashisa), kufanele baye egumbini lezimo eziphuthumayo, kusho uDkt Cram. Futhi-ke mhlawumbe babeyophelela egumbini labagula kakhulu begadiwe futhi baqiniswe ngokunakekelwa ubusuku nemini.

Alikho ikhambi leReye's syndrome, ngakho-ke ukwelashwa kuhlose ukuvikela ubuchopho ekulimaleni okuqhubekayo, ukuzama ukubuyisela emuva izingqinamba zemethambo ezibangela ubuchopho ukuba buvuvukale, kuqinisekiswe ukuthi amaphaphu aqhubeka nokusebenza ngezindlela ezifana nethambo lokuphefumula noma i-ventilator, futhi ukunciphisa ukucindezela komzimba jikelele okunganciphisa ukuboshwa kwenhliziyo.

Ungasebenzisa umshini wokuphefumula ukuze uvuselele umuntu one-Reye's syndrome, engasiza ngokuvuvukala kobuchopho, kusho uDkt Cram. Kukhona nemithi (efana ne- mannitol noma dexamethasone ) ungabanika okungasiza ngokuvuvukala.

Ukwelashwa kungasiza ekunciphiseni ukuqhubeka kwe-Reye's syndrome, futhi amacala amancane angaqhubeki angadala izinkinga zesikhathi eside.

Ungayivimba kanjani i-Reye's syndrome

1. Izidakamizwa okufanele uzigweme (ngaphezu kwe-aspirin)

Kungenzeka kungenzeki ukuvimbela wonke amacala e-Reye's syndrome, njengoba amanye amacala angaxhunyanisiwe ne-aspirin. Kodwa-ke, amathuba okuthola lesi sifo esingajwayelekile ehla kakhulu ngokuqinisekisa ukuthi izingane ezinesifo segciwane azithathi noma yimiphi imishanguzo equkethe i-acetylsalicylic acid, i-salicylic acid, i-acetylsalicylate, noma i-salicylate compounds. Ngokungeziwe ku-aspirin, lokhu kufaka le mithi engaphezulu kwekhawunta:

• U-Alka-Seltzer
• Anacin
• I-Ascriptin
• I-Bufferin
• IDoan’s
• I-Ecotrin
• I-Excedrin
• Kaopectate
• Maalox
• Pamprin
• UPepto-Bismol

Lolu akulona uhlu oluphelele. Khuluma nomhlinzeki wezingane zakho noma usokhemisi ngolwazi olungeziwe. Kubalulekile ukuthi abazali nentsha ifunde wonke amalebula emithi yokwelashwa ngaphambi kokuyithatha.

2. Ukugoma

Ngaphezu kokugwema leyo mithi, unganciphisa ingozi yengane yakho yokuthola ukutheleleka ngegciwane kwasekuqaleni ngokugoma izingane zakho kuzo zonke izifo ezivikelwa ngumuthi wokugoma, kepha ikakhulukazi umkhuhlane (umkhuhlane) noma i-varicella (inkukhu) njengoba lena izifo ezivame kakhulu ezivikelwe ngokugomela umuthi wokugoma. Izingane zithola imigomo ye-varicella eneminyaka eyizinyanga eziyi-12 neminyaka engu-4 futhi kufanele zithole umuthi wokugomela umkhuhlane unyaka nonyaka.

3. Ukudambisa izinhlungu okuphephile nokunciphisa imfiva

Okuhlukile kumthetho we-no-aspirin yizingane ezinezimo eziphendula kahle ekwelashweni kwe-aspirin, njengesifo seKawasaki. Kulezo zimo, abazali kufanele babonane nodokotela ngaphambi kokuhlinzeka ngemithi yokubulala izinhlungu noma yokulwa nokuvuvukala. Okwezinye izingane, i-acetaminophen (iTylenol) noma ibuprofen (Motrin) Kunconywa njalo esikhundleni se-aspirin, ikakhulukazi ngezifo ezibangelwa amagciwane.